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This is VAERS ID 1044957

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1044957
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2020-12-31
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Chills, Malaise

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-07
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiac disorder; Disorder renal
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021160561

Write-up: Weakness; malaise; chills; This is a spontaneous report from a non-contactable consumer downloaded from the regulatory authority-WEB DE-PEI-PEI2021002504. An elderly male patient was vaccinated with the first dose of bnt162b2 (COMIRNATY), via an unspecified route of administration on 31Dec2020 at single dose for COVID-19 immunisation. Medical history included disorder renal and cardiac disorder, both from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. On 01Jan2021 after vaccination the patient developed Malaise and Weakness and Chills and Exitus letalis, lasting for unknown. The patient died on 07Jan2021. It was not reported if an autopsy was performed. The outcome of events Malaise, Weakness and Chills was fatal. The cause of death was Malaise, Weakness and Chills. No follow-up attempts are possible; Information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Weakness; malaise; chills

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